Mayo Clinic strongly supports President Obama’s call for health insurance reform and health care delivery reform, and agrees with the President’s position that the status quo is not acceptable. We believe that a bipartisan, collaborative approach is essential to achieving significant, patient-centered health care reform.

Mayo Clinic and the many organizations and individuals working with us in the Mayo Clinic Health Policy Center are strongly in favor of reform of both health care delivery and health insurance. True health care reform is getting better results for the money spent. Better results for money spent is what we meant by high value health care: better outcomes, safer care, better service and at lower costs over time. And this will translate to better access to medical services for all Americans.

We agree with President Obama’s focus on insuring all Americans and reforming the health care payment reform.

Pretty solid endorsement. Of course the cynical part of me is wondering if they aren't happy because they will be making huge profits from the reform plan.

An article published last week on the Wall Street Journal's Health Blog quotes Cleveland Clinic CEO Toby Cosgrove as lamenting the fact that he cannot legally refuse to hire morbidly obese individuals and as supporting stigmatization of, and discrimination against, overweight individuals.

The Cleveland Clinic has deemed smokers to be unsuitable for employment. New employees are required to undergo a cotinine test and are refused employment if testing indicates that they smoke or use smokeless tobacco.

Now, it appears that smokers may be just the first group that the Cleveland Clinic is trying to purge from its work force. The overweight and obese appear to be next, as soon as Cosgrove gets word that it is only the morbidly obese who are protected by federal law.

While the Americans with Disabilities Act protects individuals who are morbidly obese, it does not protect those who are merely obese or overweight. Thus, there is nothing to stop the Cleveland Clinic from refusing to hire anyone who is overweight or obese. The Cleveland Clinic is perfectly free to make being thin a requirement for employment. And it's frightening to know that its CEO is even thinking about doing so.

To be clear, what the Cleveland Clinic is doing is discriminating against smokers in employment. They are justifying this selective and targeted employment discrimination on the grounds that it is important to promote a healthy workforce. Yet they show no desire to actually promote a healthy workforce by making sure that prospective employees are actually healthy. They can be as unhealthy as they want to be, as long as they don't smoke and are not over weight.

What's next? Refusal to give smokers and obese/over weight people health care at the Cleveland Clinic?